Bullous Erythema Multiforme
UMLS: C0038325
Basic Information
Severity Level:
Severe
Definition:
Rare cutaneous eruption characterized by extensive KERATINOCYTE apoptosis resulting in skin detachment with mucosal involvement. It is often provoked by the use of drugs (e.g., antibiotics and anticonvulsants) or associated with PNEUMONIA, MYCOPLASMA. It is considered a continuum of Toxic Epidermal Necrolysis.
UMLS ID:
C0038325
MeSH ID:
Synonyms:
Bullous Erythema Multiforme
Erythema Multiforme Exudativum
Ectodermosis Erosiva Pluriorificialis
Erythema Multiforme Bullosum
Erythema Multiforme Bullosum (Stevens Johnson Syndrome)
Erythema Multiforme Major
Erythema Multiforme Bullosum
Erythema Multiforme Exudativum
Erythema Multiforme Major
Erythema Multiforme, Stevens-Johnson Type
Febrile Mucocutaneous Syndrome
Steven Johnson Syndrome
Stevens Johnson Syndrome
Stevens Johnson Syndrome
Stevens Johnson Syndrome
Stevens-Johnson
Stevens-Johnson Syndrome
Stevens-Johnson Syndrome
Pharmacogenomic Information
PharmGKB
PharmGKB References:
Risk-Increasing Variants (55)
CYP2C9*1, CYP2C9*3
Effect:
Risk Increase
GSTM1 non-null, GSTM1 null
Effect:
Risk Increase
HLA-A*02:01
Effect:
Risk Increase
HLA-A*02:06
Effect:
Risk Increase
HLA-A*02:07
Effect:
Risk Increase
HLA-A*11:01
Effect:
Risk Increase
Risk-Decreasing Variants (6)
HLA-A*02:01
Effect:
Risk Decrease
HLA-A*24:02
Effect:
Risk Decrease
HLA-A*31:03
Effect:
Risk Decrease
HLA-DQB1*05:01
Effect:
Risk Decrease
HLA-DRB1*04:05
Effect:
Risk Decrease
rs77491650
Effect:
Risk Decrease
Total Variants:
61
Risk Increase:
55
Risk Decrease:
6
Classification Hierarchy
MeSH Tree Number breakdown for C0038325
C07
Stomatognathic Diseases
C07.465
Mouth Diseases
C07.465.864
Stomatitis
C17
Skin and Connective Tissue Diseases
C17.800
Skin Diseases
C17.800.174
Dermatitis
C17
Skin and Connective Tissue Diseases
C17.800
Skin Diseases
C17.800.229
Erythema
C17
Skin and Connective Tissue Diseases
C17.800
Skin Diseases
C17.800.865
Skin Diseases, Vesiculobullous
C17.800.865.475
Erythema Multiforme
C20
Immune System Diseases
C20.543
Hypersensitivity
C25
Chemically-Induced Disorders
C25.100
Drug-Related Side Effects and Adverse Reactions
ADE Molecular Mechanism Mapping
Drug-ADE-Human Protein Triplets
Molecular mechanism triplets showing drug-adverse event-protein relationships
325
Total Triplets
162
High Confidence
Loading Drug-ADE-Protein triplets...
Personalized Drug-Protein-ADE Network
Comprehensive Information for Personalized ADE
Comprehensive Information and Reliability for Drug-ADE Association
Drug Confidence Filter
DTA Confidence Level
Layout Style
Show Labels
Total Drugs
1198
60 High |
154 Medium |
984 Low Confidence
Total Proteins
40
Target proteins associated with this ADE
Drug-Protein-ADE association
2917
2 Known |
160 High |
163 Middle |
2592 Low Confidence
Confidence Profile
11%
Known/High/Middle-confidence interactions
This interactive network visualization shows the relationships between the top 50 drugs (ranked by case number) out of 1198 total drugs associated with this adverse event, their known and potential off-target proteins, and the associated adverse effect. The connections indicate binding interactions and mechanistic pathways.
Adverse Drug Event (ADE)
Drug
Protein
Drug-Center
Human Protein-Center
confidence level
Drug Confidence Level Distribution
Drug Type Distribution
Loading ADE information...
Pharmacological Target Class Distribution
Top 8 Function Target Sub Classes
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The Introduction of Drug-AE Confidence Score Grade
| Priority Level | Score Range | Description | Evidence Characteristics |
|---|---|---|---|
| High | Score ≥ 6.67High-priority associations requiring immediate attention. | Strong evidence across multiple dimensions with high statistical significance, robust association measures, and substantial case numbers. Warrant priority pharmacovigilance action. | High P-value scores (significant Adjust-P), Strong ROR/PRR values, Substantial case numbers, Complete dimensional coverage, Minimal data filtering needed. |
| Medium | 3.33 ≤ Score < 6.67Medium-priority associations requiring careful evaluation. | Moderate evidence quality with acceptable statistical significance and association strength. May need additional validation or monitoring before definitive action. | Moderate P-value significance, Reasonable ROR/PRR measures, Adequate case numbers, Partial dimensional coverage, Some data quality considerations. |
| Low | Score < 3.33Low-priority associations with limited evidence strength. | May represent weak signals, insufficient data, or associations requiring extensive additional investigation before any regulatory or clinical consideration. | Weak P-value significance, Low association measures, Limited case numbers, Incomplete dimensional data, Significant data filtering applied. |
The Introduction of Drug-AE Severity Score Grade
| Severity Level | Score Range | Description | Typical outcomes |
|---|---|---|---|
| Minimal | 0 ≤ Score ≤ 0.387 Low severity ADRs requiring minimal intervention. | Events that need medical attention to prevent permanent damage but without hospitalization or life-threatening consequences. | Primarily RI (Required Intervention) outcomes, Outpatient management, Preventive measures, Early intervention prevents escalation. |
| Mild | 0.387 < Score ≤ 0.861 Mild severity events requiring hospitalization. | Mix of intervention-required and hospitalization cases with manageable clinical outcomes and good recovery potential. | Mix of RI and HO outcomes, Initial or prolonged hospitalization, Active medical management, Generally favorable prognosis. |
| Moderate | 0.861 < Score ≤ 1.500 Moderate ADRs resulting in permanent disability. | Higher proportion of hospitalization and disability cases requiring intensive medical management and long-term care planning. | Increased HO and DS outcomes, Permanent disability, Extended hospitalization, Rehabilitation required, Long-term functional impairment. |
| Severe | 1.500 < Score ≤ 2.52High severity life-threatening events with significant morbidity. | Notable presence of disability and life-threatening outcomes requiring emergency intervention and intensive care management. | Prominent DS and LT outcomes, Life-threatening events, Emergency intervention required, ICU admission, High risk of permanent consequences. | Critical | 2.524 < Score ≤ 5.000Critical life-threatening or fatal ADRs with maximum clinical impact. | High proportion of life-threatening events and deaths with very strong drug-event associations requiring immediate regulatory action. | Significant LT and DE outcomes, Fatal events, Emergency life-support measures, Immediate drug discontinuation, Regulatory safety alerts. |
The Introduction of Drug-AE-Protein Confidence Score Grade
| Confidence Level | Relationships | Description | Evidence Types |
|---|---|---|---|
| Known/Valid | Direct DTA relationships | The drug-ADE, drug-target, and target-ADE associations are all derived from the same literature source. | Experimental validation, Clinical evidence |
| High | DT + TA + DA | Two of the three associations (drug-ADE, drug-target, and target-ADE) are derived from the same literature source, while the third is validated by other literature. | Multiple corroborating sources |
| Medium | DT + TA + DA | Two of the three associations (drug-ADE, drug-target, and target-ADE) are validated by separate literature sources. | Partial evidence chain |
| Low | TA + DT | Only target-ADE and drug-target associations are validated by literature sources. | Associative evidence only |
Personalized ADE
Route and Formulation-specified Associations
Pharmaceutic Granularity for Route and Formulation specification
Administration Routes (Total: 10989 cases across 26 routes)
Dosage Forms (Total: 3019 cases across 27 forms)
Drug Route Analysis
Drug Form Analysis
Drug Route Analysis
| Route | Drug Name | Case Number | Confidence Score | Confidence Level | Severity Score | Severity Level | Details | ||
|---|---|---|---|---|---|---|---|---|---|
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Drug Form Analysis
| Form | Drug Name | Case Number | Confidence Score | Confidence Level | Severity Score | Severity Level | Details | ||
|---|---|---|---|---|---|---|---|---|---|
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Disease-stratified Associations
Personalized Granularity for Disease and Indication Stratification
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Indication Name
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Drug Name
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Case Number
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Confidence Score
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Confidence Level
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Severity Score
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Severity Level
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Details |
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DEV TOOL
